BRATON FREDLINE (PA-C) – Physician Assistant, NPI 1740733401
Physician Assistant
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
6,066 PHYSICIAN ASSISTANT in MI
Provider Addresses for BRATON FREDLINE (PA-C)
300 68TH ST SE
GRAND RAPIDS, MI 495486927
Phone: (616) 455-5000
Type: Location
3950 17th St Ste A
Baker City, OR 978141300
Phone: (541) 523-1001
Fax: (541) 523-1152
Type: Location
Shoup Avenue West, Twin Falls, Twin Falls County, Idaho, 83301, United States
TWIN FALLS, ID 833015042
Phone: (208) 814-9100
Type: Location
3950 17TH ST STE A
BAKER CITY, OR 978141300
Phone: (541) 523-1001
Fax: (541) 523-1152
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $49.
Total Amount is formed as General ($49) + Research ($0) + Ownership ($0) = $49.
Last reported payment date: 2023-06-07 • Largest payer in this snapshot: ITI, Inc. ($49).
Total Amount
$49
General + Research + Ownership
Payments
1
Total payment records
General Amount
$49
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-06-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ITI, Inc. | $49 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-05-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190208000353 | I | Physician Assistant | OR | TBD |
| I20240504000245 | I | Physician Assistant | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 36415 | Insertion of needle into vein for collection of blood sample | 47 | 24 | $0 |
Insurance plans in this area (ZIP 49548)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | MI | |
| Clinical Social Worker | IA | |
| P S Y C H I A T R Y | MI | |
| Clinical Psychologist | MI | |
| - | MI | |
| Mental Health Counselor | MI | |
| Clinical Social Worker | NY | |
| Clinical Social Worker | MI | |
| Clinical Psychologist | MI | |
| Clinical Social Worker | MI |
Reviews
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